Translumbar and transsacral motor-evoked potentials: A novel test for spino-anorectal neuropathy in spinal cord injury

Kasaya Tantiphlachiva, Ashok Attaluri, Jessica Valestin, Thoru Yamada, Satish Sanku Chander Rao

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objectives: Spinal cord injury (SCI) causes anorectal problems, whose pathophysiology remains poorly characterized. A comprehensive method of evaluating spino-anorectal function is lacking. The aim of this study was to investigate the neuropathophysiology of bowel dysfunction in SCI by evaluating motor-evoked potentials (MEP) of anus and rectum following transspinal magnetic stimulation and anorectal physiology. Methods: Translumbar and transsacral magnetic stimulations, anorectal manometry, and pudendal nerve terminal motor latency (PNTML) were performed in 39 subjects with SCI and anorectal problems and in 14 healthy controls, and data were compared. MEPs were recorded with an anorectal probe containing bipolar ring electrodes. Results: The MEPs were significantly prolonged (P0.05) bilaterally, and at lumbar and sacral levels, as well as at rectal and anal sites in SCI subjects compared with controls. A total of 95% of SCI subjects had abnormal MEPs and 53% had abnormal PNTML. All subjects with abnormal PNTML also demonstrated abnormal MEP, but 16/17 subjects with normal PNTML had abnormal MEP. Overall, SCI patients had weaker anal sphincters (P0.05), higher prevalence of dyssynergia (85%), and altered rectal sensation (82%). Conclusions: Translumbar and transsacral MEPs revealed significant and hitherto undetected lumbosacral neuropathy in 90% of SCI subjects. Test was safe and provided neuropathophysiological information that could explain bowel dysfunction in SCI subjects.

Original languageEnglish (US)
Pages (from-to)907-914
Number of pages8
JournalAmerican Journal of Gastroenterology
Volume106
Issue number5
DOIs
StatePublished - May 1 2011
Externally publishedYes

Fingerprint

Motor Evoked Potentials
Spinal Cord Injuries
Pudendal Nerve
Anal Canal
Manometry
Ataxia
Rectum
Electrodes

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Translumbar and transsacral motor-evoked potentials : A novel test for spino-anorectal neuropathy in spinal cord injury. / Tantiphlachiva, Kasaya; Attaluri, Ashok; Valestin, Jessica; Yamada, Thoru; Rao, Satish Sanku Chander.

In: American Journal of Gastroenterology, Vol. 106, No. 5, 01.05.2011, p. 907-914.

Research output: Contribution to journalArticle

Tantiphlachiva, Kasaya ; Attaluri, Ashok ; Valestin, Jessica ; Yamada, Thoru ; Rao, Satish Sanku Chander. / Translumbar and transsacral motor-evoked potentials : A novel test for spino-anorectal neuropathy in spinal cord injury. In: American Journal of Gastroenterology. 2011 ; Vol. 106, No. 5. pp. 907-914.
@article{25e6da99fe8e42c294782d3a9f6d6143,
title = "Translumbar and transsacral motor-evoked potentials: A novel test for spino-anorectal neuropathy in spinal cord injury",
abstract = "Objectives: Spinal cord injury (SCI) causes anorectal problems, whose pathophysiology remains poorly characterized. A comprehensive method of evaluating spino-anorectal function is lacking. The aim of this study was to investigate the neuropathophysiology of bowel dysfunction in SCI by evaluating motor-evoked potentials (MEP) of anus and rectum following transspinal magnetic stimulation and anorectal physiology. Methods: Translumbar and transsacral magnetic stimulations, anorectal manometry, and pudendal nerve terminal motor latency (PNTML) were performed in 39 subjects with SCI and anorectal problems and in 14 healthy controls, and data were compared. MEPs were recorded with an anorectal probe containing bipolar ring electrodes. Results: The MEPs were significantly prolonged (P0.05) bilaterally, and at lumbar and sacral levels, as well as at rectal and anal sites in SCI subjects compared with controls. A total of 95{\%} of SCI subjects had abnormal MEPs and 53{\%} had abnormal PNTML. All subjects with abnormal PNTML also demonstrated abnormal MEP, but 16/17 subjects with normal PNTML had abnormal MEP. Overall, SCI patients had weaker anal sphincters (P0.05), higher prevalence of dyssynergia (85{\%}), and altered rectal sensation (82{\%}). Conclusions: Translumbar and transsacral MEPs revealed significant and hitherto undetected lumbosacral neuropathy in 90{\%} of SCI subjects. Test was safe and provided neuropathophysiological information that could explain bowel dysfunction in SCI subjects.",
author = "Kasaya Tantiphlachiva and Ashok Attaluri and Jessica Valestin and Thoru Yamada and Rao, {Satish Sanku Chander}",
year = "2011",
month = "5",
day = "1",
doi = "10.1038/ajg.2010.478",
language = "English (US)",
volume = "106",
pages = "907--914",
journal = "American Journal of Gastroenterology",
issn = "0002-9270",
publisher = "Nature Publishing Group",
number = "5",

}

TY - JOUR

T1 - Translumbar and transsacral motor-evoked potentials

T2 - A novel test for spino-anorectal neuropathy in spinal cord injury

AU - Tantiphlachiva, Kasaya

AU - Attaluri, Ashok

AU - Valestin, Jessica

AU - Yamada, Thoru

AU - Rao, Satish Sanku Chander

PY - 2011/5/1

Y1 - 2011/5/1

N2 - Objectives: Spinal cord injury (SCI) causes anorectal problems, whose pathophysiology remains poorly characterized. A comprehensive method of evaluating spino-anorectal function is lacking. The aim of this study was to investigate the neuropathophysiology of bowel dysfunction in SCI by evaluating motor-evoked potentials (MEP) of anus and rectum following transspinal magnetic stimulation and anorectal physiology. Methods: Translumbar and transsacral magnetic stimulations, anorectal manometry, and pudendal nerve terminal motor latency (PNTML) were performed in 39 subjects with SCI and anorectal problems and in 14 healthy controls, and data were compared. MEPs were recorded with an anorectal probe containing bipolar ring electrodes. Results: The MEPs were significantly prolonged (P0.05) bilaterally, and at lumbar and sacral levels, as well as at rectal and anal sites in SCI subjects compared with controls. A total of 95% of SCI subjects had abnormal MEPs and 53% had abnormal PNTML. All subjects with abnormal PNTML also demonstrated abnormal MEP, but 16/17 subjects with normal PNTML had abnormal MEP. Overall, SCI patients had weaker anal sphincters (P0.05), higher prevalence of dyssynergia (85%), and altered rectal sensation (82%). Conclusions: Translumbar and transsacral MEPs revealed significant and hitherto undetected lumbosacral neuropathy in 90% of SCI subjects. Test was safe and provided neuropathophysiological information that could explain bowel dysfunction in SCI subjects.

AB - Objectives: Spinal cord injury (SCI) causes anorectal problems, whose pathophysiology remains poorly characterized. A comprehensive method of evaluating spino-anorectal function is lacking. The aim of this study was to investigate the neuropathophysiology of bowel dysfunction in SCI by evaluating motor-evoked potentials (MEP) of anus and rectum following transspinal magnetic stimulation and anorectal physiology. Methods: Translumbar and transsacral magnetic stimulations, anorectal manometry, and pudendal nerve terminal motor latency (PNTML) were performed in 39 subjects with SCI and anorectal problems and in 14 healthy controls, and data were compared. MEPs were recorded with an anorectal probe containing bipolar ring electrodes. Results: The MEPs were significantly prolonged (P0.05) bilaterally, and at lumbar and sacral levels, as well as at rectal and anal sites in SCI subjects compared with controls. A total of 95% of SCI subjects had abnormal MEPs and 53% had abnormal PNTML. All subjects with abnormal PNTML also demonstrated abnormal MEP, but 16/17 subjects with normal PNTML had abnormal MEP. Overall, SCI patients had weaker anal sphincters (P0.05), higher prevalence of dyssynergia (85%), and altered rectal sensation (82%). Conclusions: Translumbar and transsacral MEPs revealed significant and hitherto undetected lumbosacral neuropathy in 90% of SCI subjects. Test was safe and provided neuropathophysiological information that could explain bowel dysfunction in SCI subjects.

UR - http://www.scopus.com/inward/record.url?scp=79955638394&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79955638394&partnerID=8YFLogxK

U2 - 10.1038/ajg.2010.478

DO - 10.1038/ajg.2010.478

M3 - Article

C2 - 21266960

AN - SCOPUS:79955638394

VL - 106

SP - 907

EP - 914

JO - American Journal of Gastroenterology

JF - American Journal of Gastroenterology

SN - 0002-9270

IS - 5

ER -